Medical Specialties Commons^™

Psychiatric Manifestation Of Vitamin B-12 Deficiency: An Update, David Metzler, M.S., M.D., William H. Miller, M.D., C. Stephen Edwards, M.D.

Jefferson Journal of Psychiatry

Psychiatric manifestations of vitamin B-12 deficiency are reviewed from 1986 to the present. Specific clinical entities reviewed include depression, organic psychosis, obsessive-compulsive disorder, childhood manifestations and dementia. We recommend that consideration be given to B-12 deficiency as an etiological factor in some cases of depression, organic psychosis, certain childhood disorders and dementia. Routine screening of people overage 65 is addressed.

Psychiatric Consultation For The Demented Elderly, Kenneth Paul Rosenberg, M.D.

Jefferson Journal of Psychiatry

Psychiatric consultations for the demented elderly are often required and requested by the Medical service. With the rise in the number of demented elderly being housed in acute care hospitals, the need.for these consultations is increasing. In this paper, the author presents a case and discusses the role of the consultant in (1) diagnostics, (2) therapeutics, (3) assessment of involuntary vs. voluntary placement in an institution, (4) medical staff education, (5) family education, and (6) the management of evoked feelings and countertransference among the medical and nursing staff.

Hiv-Positivity, Aids, And The Military Psychiatry Residency Experience, Ronald J. Koshes, M.D.

Jefferson Journal of Psychiatry

Psychiatry residents in the military work with a diverse population of HIV-positive and AIDS patients who are in various stages in their illnesses, military careers, and acceptance of the disease process. In this circumstance, the military psychiatry resident must be a clinician, administrator, and patient advocate. Additionally, the military resident must uphold Department of Defense regulations which mandate that soldiers be both physically and emotionally fit to perform their duties. This paper describes the unique role of the military psychiatrist in working with HIV-positive and AIDS patients in the military setting.

The Management Of Performance Anxiety With Beta-Adrenergic Blocking Agents, James A. Bourgeois, M.D.

Jefferson Journal of Psychiatry

Performance anxiety consists of several symptoms experienced in the context of public performance and is classified in DSM-III-R under social phobia. Performance anxiety must be distinguished from panic disorder, generalized social phobia, and generalized anxiety disorder. Performance anxiety symptoms can be detrimental to both performer and performance. These symptoms can be controlled by the judicious use of beta-adrenergic blocking agents. The use of beta-adrenergic blocking agents should be considered as part of a psychiatric stress-management program for these patients.

Psychiatry And Cardiac Transplantation, Mark Graham, M.D.

Jefferson Journal of Psychiatry

This paper explores the role of psychiatry in the field of cardiac transplantation by way of a literature review. The various stages of cardiac transplantation are discussed with respect to their time frame within the transplantation process, the cognitive and emotional reactions of patients within a given stage, and the dynamics of staff, patient, and family interactions. Research and clinical experience in the field suggest psychiatric assessment, follow-up, and, when necessary, intervention are valuable and important in promoting successful psychological adjustment as patients face their adaptive tasks in the various stages of the transplantation process.

Mead Johnson Award

Jefferson Journal of Psychiatry

The Mead Johnson Award has been established to honor the best paper submitted during each calendar year to The Jefferson Journal of Psychiatry:A Resident Publication. An award of one thousand dollars is given to the chosen author, with an additional one thousand dollars to be given to the residency program or fellowship in which the author is enrolled. The winning submission will be selected by the Journal's editorial board from manuscripts submitted on any subject related to psychiatric practice and/or research. We invite authors to review the Information for Contributors section of this issue. The board will announce the 1991 …

Editor's Column, Edward Kim, M.D.

Jefferson Journal of Psychiatry

As a senior medical student applying to residency programs, I became acquainted with the term "eclecticism." Many programs described themselves as "eclectic"; it appealed to the progressive, pluralistic spirit in all of us. Yet it implied, erroneously I believe, that limiting the foci of psychiatric resident education was neither necessary nor desirable. The regressive appeal of eclecticism lies in the denial that all true commitments entail some relinquishment of other possibilities; the pleasures of socialization are bought through the renunciation of defecating or urinating at the slightest urge. The hypothetical eclectic psychiatrist has given up none of his or her …

Editorial Staff

Jefferson Journal of Psychiatry

Editorial Staff for Jefferson Journal of Psychiatry, Volume 9, Number 2, 1991.

About The Authors

Jefferson Journal of Psychiatry

About the Authors, Jefferson Journal of Psychiatry, Volume 9, Number 1, 1991.

Letters To The Editor

Jefferson Journal of Psychiatry

Letters to the Editor, Jefferson Journal of Psychiatry, Volume 9, Number 1, 1991.

Bringing Back The Mind, Edward Kim, M.D.

Jefferson Journal of Psychiatry

PSYCHODYNAMIC PSYCHIATRY: THEORY AND PRACTICE

John Frosch, M.D. 1990

International Universities Press

Vol I, 359pp, $50.00

Vol II, 505pp, $60.00

Death, Freedom, Isolation And Uncertainty, Cordula Holzer, M.D.

Jefferson Journal of Psychiatry

LOVE'S EXECUTIONER & OTHER TALES OF PSYCHOTHERAPY

Irvin Yalom, M.D. New York, Basic Books, 1989

288 pp.$ 19.95 (Hardcover) 9.95 (Paperback)

Successful Private Practice In The 1990s, Susan Marcel, D.O.

Jefferson Journal of Psychiatry

SUCCESSFUL PRIVATE PRACTICE IN THE 1990s

Joan Kay Beigel, M.Ed. and Ralph H. Earle, Ph.D. with Lynn Fleischman and

Ritalinda D'Andrea Brunner

Mazell Publishers, 1990

$21.95

224 Pages

The Barking Man: A Case Study Of Rootwork In Psychiatry, Harry D. Goldwasser, M.D.

Jefferson Journal of Psychiatry

Cultures and sub-cultures attempt to describe illness in ways that are most understandable to the people who live in that community. These groups may differ when describing the etiology, course and treatment of any given ailment. Mental illness is just as susceptible to being explained in a manner which differs from group to group. Not surprisingly, psychiatrists trained under the auspices of "mainstream America"-that is, where the Western Judeo-Christian paradigm reigns, may find themselves dismissing symptoms of other sub-cultures. Some patients may have manifestations of true mental illness; others may have symptoms which are culturally sanctioned but which we label …

Conceptualization Of Therapeutic Alliance During Psychiatric Residency Training, Stephen J. Cozza, M.D.

Jefferson Journal of Psychiatry

This pilot study defines the Conceptualization of Therapeutic Alliance (CTA) as the psychotherapist's internalized construct if his ideal patient-therapist relationship based on the principles if Therapeutic Alliance, Working Alliance, and Helping Alliance. The study measures the CTA if third year medical students (MS3s), third year psychiatry residents (PCY3s), and consultant supervising psychotherapists (CSs) utilizing Fiedler's Ideal Therapeutic Relationship Scale. The CTA profiles of each experimental group are correlated with Fiedler's Ideal Therapeutic Relationship. Variance in CTA profiles within each group is also calculated. Preliminary results if this small study (N = 24) show that CTA measurements if the PCY3 group …

Occupational Chemical Exposures And Psychiatric Disorders, Mark L. Dembert, M.D., M.P.H.

Jefferson Journal of Psychiatry

Occupational exposure to metals, solvents, or pesticides can produce disorders of behavior, thought, or mood which can easily be misdiagnosed as 'Junctional." Accurate diagnosis obtained with a relevant clinical history, psychiatric interview, physical examination, and indicated laboratory tests will enable the delivery of necessary medical treatment and concurrently prevent repeat exposure to a hazardous work environment. Published references and organizational sources in occupational medicine and industrial hygiene can beutilized by psychiatrists for determination of the dijferential diagnosis and confirmation of an occupational exposure; in addition, these references can aid in assessing the need for an environmental health hazard survey at …

Subsequent Pregnancy In Women With A History Of Postpartum Psychosis, Richard G. Hersh, M.D.

Jefferson Journal of Psychiatry

Postpartum psychosis stands out among the psychiatric syndromes associated with child birth, not able for the variability of its symptom profile and the potential severity of its course, if unrecognized. Significant questions regarding nosology, etiology, prevention and treatment remain only partially answered (1). While controversy surrounds many of the critical issues regarding postpartum psychosis, including its definition, current epidemiologic data indicates severe, frequently psychotic episodes occur following 1-2 per 1,000 of all births (2). As diagnosis and treatment of puerperal conditions have evolved, clinicians now are frequently involved in assisting women with a history of postpartum psychosis with decision making …

Transference Love And Countertransference Love In Clinical Technique, Ronald J. Koshes, M.D., Colleen E. Sari, M.D.

Jefferson Journal of Psychiatry

The authors review the original and modern concepts of transference and countertransference love as described by Sigmund Freud followed by the more recent theories of Heinz Kohut and Otto Kernberg, focusing on dynamic clinical importance. Case examples are presented to illustrate the important clinical presentations, problems and pitfalls as well as techniques of managing the eroticized transference. The countertransference implications are especially explored as well as indications for supervision.

A Survey Of Selected Neurological Signs In Schizophrenia Research, Emanuel H. Rosen, M.D.

Jefferson Journal of Psychiatry

This review covers three areas of schizophrenia research not usually addressed in residents' curricula: smooth pursuit eye movements and genetics, orienting responses, and tardive dyskinesia. The significance of these neurological signs is explored in terms of their clinical symptom associations and their heuristic value. Neuroanatomical aspects of these signs is noted to be speculatively consistent with hypofrontality and negative symptoms in schieophrenia. The author describes the nature of occulomotor abnormalities and discusses an applicable research study. He summarizes relevant areas of genetic research including linkage analysis and marker studies and explains some of the orienting response abnormalities in schizophrenia. He …

Depression And Poverty Ii. Strategies For Intervention, Donald C. Ohuoha, M.D., M.P.H.

Jefferson Journal of Psychiatry

In Part I of this paper, I reviewed the recent findings in psychosocial causes of depression among the poor, and questions raised by them. In this paper, I will suggest certain strategies for intervention for treatment of this population.

Depression And Poverty I. Psychosocial And Cultural Determinants, Donald C. Ohuoha, M.D., M.P.H.

Jefferson Journal of Psychiatry

The WorldHealth Organization estimates that over 100 million people worldwide suffer from depression, that three times as many may be affected (1). While major advances have occurred in our understanding of the biological aspects of depression, the understanding of psychosocial causes of depression is still largely sketchy. Thus adequate intervention in dealing with this aspect of treatment of depression is scarce. This paper, divided into two parts, will review recent findings in psychosocial causes of depression and suggest certain strategies.for intervention, speculate on the roles of poverty and the issues raised by poverty on the rates of depression and suggest …

Multiple Personality And Channeling, Rayna L. Rogers, D.O.

Jefferson Journal of Psychiatry

Psychiatry in the 1980's and 1990's has seen a rapid progression in the understanding of dissociative disorders, especially multiple personality disorder. Another phenomenon which has had a parallel rise in the past decade is trance channeling. Channeling is the process by which an individual enters a trance-like state and surrenders control of the body to a "guide" or "entity" who communicates with the listeners or "sitters" gathered for a "reading." The purpose of this paper is to investigate the relationship between these two phenomena, specifically questioning whether channeling is a variant of multiple personality disorder or if it is pathological.

Editor's Column, Edward Kim, M.D.

Jefferson Journal of Psychiatry

He sat on the other side of the large government-issue desk, a bland, a pathetic expression on his face. His vague, contradictory story of visual and auditory hallucinations was punctuated by frequent pauses and "you know,"as if he were expecting me to help him fabricate his symptoms. He himself didn't seem to be trying very hard to convince me of his alleged distress. It would have been simple to admit him; the paperwork was minimal, and there were plenty of beds. I mentioned my skepticism of his history as I told him why I wouldn't admit him. The ensuing flood …

Editorial Staff

Jefferson Journal of Psychiatry

Editorial Staff for Jefferson Journal of Psychiatry, Volume 9, Number 1, 1991

About The Authors

Jefferson Journal of Psychiatry

About the Authors. Jefferson Journal of Psychiatry, Volume 8, Number 2, 1990.

Letters To The Editor

Jefferson Journal of Psychiatry

Letters to the Editor, Jefferson Journal of Psychiatry, Volume 8, Number 2, 1990.

Effective Psychotherapy With Borderline Patients, Edward Kim, M.D.

Jefferson Journal of Psychiatry

Robert Waldinger, M.D.

John G. Gunderson, M.D.

American Psychiatric Press, 1987

227 pages

$27.50

Psychodynamic Psychiatry In Clinical Practice, Edward Kim, M.D.

Jefferson Journal of Psychiatry

Glen O. Gabbard, M.D.

American Psychiatric Press, 1990

480 pages $49.95

Legislating Psychiatry, Carla Rodgers, M.D.

Jefferson Journal of Psychiatry

REVIEW OF CLINICAL PSYCHIATRY AND THE LAW, VOL. I

Edited by Robert Simon, M.D.

American Psychiatric Press, 1989, 416 pages, $38.50

Dr. Freud Vs. Dr. Spock, Timothy C. Smith, M.D.

Jefferson Journal of Psychiatry

CHILDREN OF PSYCHIATRISTS AND OTHER PSYCHOTHERAPISTS

Thomas Maeder

Harper and Row publishers, New York 1989, 259 pages, $19.95.